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Successful treatment of enteroatmospheric fistulas in combination with negative pressure wound therapy: Experience on 3 cases and literature review
Authors:Ulrich Wirth  Bernhard W Renz  Dorian Andrade  Tobias S Schiergens  Helmut Arbogast  Joachim Andrassy  Jens Werner
Institution:Department of General, Visceral and Transplantation Surgery, Hospital of the University of Munich, Munich, Germany
Abstract:Enteroatmospheric fistulas (EAF) are rare but challenging and morbid complications of abdominal surgery and require time‐ as well as resource‐consuming management. Furthermore, they severely affect patients' quality of life. Several treatment modalities for EAF management are described in the literature. We describe 3 consecutive cases of EAF treatment by employing negative pressure wound therapy (NPWT) along with either a special silicone fistula adapter or a Silo‐Vac‐like system in another case to isolate the fistula from the remaining abdominal wound. Spontaneous fistula closure was achieved in 2 of the 3 cases, and surgical resection of the small bowel segment harbouring EAF opening was possible in a third case after wound conditioning. The rate of fistula closure was 100% (n = 3/3). Compartmentalisation of the contaminated area using NPWT accelerated healing of the open abdominal wound remarkably. In summary, we present a useful tool for the challenging management of EAF and review the literature on different treatment options of EAF available today.
Keywords:enteroatmospheric fistula  fistula adapter  fistula isolation  negative pressure wound therapy
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